Equal access to health care

1The right to health is a fundamental human right. Protection of health is an essential condition for social cohesion and economic stability and represents one of the indispensable pillars of development. Access to care is a key aspect of the right to health.

2The Parliamentary Assembly observes that inequalities in access to health care are growing in the Council of Europe member States. Various factors are at the root of this phenomenon, including financial, geographical and language barriers, corruption, socio-economic inequalities and certain migration and security policies which are unmindful of health needs. The economic crisis led to budget cuts in many countries, forced by austerity policies, thereby putting pressure on the health systems. Several countries have therefore introduced or increased charges payable by patients, particularly for essential health services.

3The Assembly notes that inequalities in access to care particularly affect vulnerable groups, including people experiencing financial problems such as the unemployed, single parent families, children, the elderly, as well as Roma, migrants, especially those in an irregular situation, and homeless people. These inequalities lead to a phenomenon of non-recourse or delayed recourse to care, which could have disastrous implications for both individual and public health and lead in the long term to an increase in health expenditure.

4Recalling its Resolution 1884 (2012) “Austerity measures – a danger for democracy and social rights”, the Assembly once again draws attention to the negative impact of austerity measures on social rights and their effects on the most vulnerable categories. In this connection, it notes with concern the impact which the economic crisis and austerity measures have had on the accessibility of care in several member countries, including Greece, which is now faced with a health, and even humanitarian crisis and an increase in xenophobic and racist acts against refugees and migrants.

5The Assembly believes that the crisis should be viewed as an opportunity to rethink health systems and be used to increase their efficiency and not as an excuse for taking retrograde measures.

6The Assembly therefore calls on the Council of Europe member States to:

6.1reduce, where appropriate, the proportion of health expenditure payable by the most disadvantaged patients and take all other necessary measures to ensure that the cost of care does not hinder access to care, including the promotion of increased use of generic drugs;

6.2ensure the accessibility of health-care facilities and health professionals throughout the territory by taking appropriate measures, having recourse where appropriate to incentive measures;

6.3ensure the accessibility of information on the health system, including vaccination and screening programmes, and set up health education programmes, while taking account of the specific needs of the different vulnerable groups and of the requirement to reduce language barriers to a minimum;

6.4simplify the administrative procedures required to be able to receive health care;

6.5introduce measures to combat corruption in the health sector, in close co-operation with the Group of States against Corruption (GRECO);

6.6dissociate their security and immigration policies from health policy, where appropriate by abolishing the obligation on health professionals to report migrants in an irregular situation;

6.7introduce training policies for health professionals stressing the need to combat arbitrary applications, discrimination and corruption in the health sector.

1The Parliamentary Assembly refers to its Resolution … (2013) on equal access to health care.

2The Assembly welcomes the recent work of the Committee of Ministers in the health field, resulting in particular in the adoption of Recommendation CM/Rec(2010)6 on good governance in health systems, Recommendation CM/Rec(2011)13 on mobility, migration and access to health care, the 2011 Committee of Ministers’ Guidelines on child-friendly health care and Recommendation CM/Rec(2012)8 on the implementation of good governance principles in health systems.

3The Assembly regrets, however, that since 2012 the Council of Europe has been without an intergovernmental committee specifically responsible for facilitating policy development and exchange of good practices in the health field.

4Having regard to the Council of Europe’s principles and values, it is of paramount importance to continue to protect the right to health enshrined in Article 11 of the European Social Charter (revised) (ETS No. 163) and to enhance the role of the European Committee of Social Rights so that it can perform this task as effectively as possible.

5In the light of the foregoing, the Assembly recommends that the Committee of Ministers:

5.1urge those member States which have not yet done so to sign and ratify the European Social Charter (revised) and the protocols thereto;

5.2take measures to ensure rapid progress towards implementation of the Charter in line with the conclusions and decisions of the European Committee of Social Rights;

5.3encourage other sectors of the Council of Europe to include health-related issues in their work, based on a cross-sectoral approach.